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Liposuction

Treatment Overview

Liposuction removes fat from your body using
suction. During liposuction, small, thin, blunt-tipped tubes (cannula) are
inserted through tiny cuts in the skin. Fat is suctioned out through these
tubes as the doctor moves the tubes around under the skin to target specific
fat deposits.

In recent years, improved techniques have made
liposuction safer, easier, and less painful. These newer techniques
include:

Tumescent liposuction. A
local anesthetic is used to numb the area of your body where
the tube will be inserted. Next, a large amount of an anesthetic solution
containing lidocaine and epinephrine is injected into the fatty tissue before
traditional liposuction is done. Tumescent liposuction may not require
general anesthesia (which makes you sleep through the
procedure).

Ultrasound-assisted liposuction. This technique uses
ultrasound to liquefy the fat, which makes it easier to remove. This technique may be particularly helpful in removing fat from the upper abdomen, sides, and back.

Laser-assisted liposuction. This technique uses low-energy waves to liquefy the fat, which is removed through a small cannula.

Liposuction is usually done as an
outpatient procedure in a properly equipped doctor's
office, ambulatory surgery center, or hospital. In general, it does not require
an overnight hospital stay unless a large volume of fat is being removed. Local anesthesia is used in some cases. And you may or
may not be given a sedative to help you relax. If a large area or volume of fat
is being treated, general anesthesia or deep sedation with a local anesthetic
may be used.

What To Expect After Treatment

After the procedure, the area of the
body that was treated is firmly wrapped to help reduce swelling, bruising, and
pain. Elastic bandages and tape, support hose (such as those used to treat
varicose veins), a special girdle, or another type of
firm-fitting garment may be used, depending on which part of the body was
treated. You may have to wear the compression garment or wrap for 3 to 4 weeks.
Expect a lot of bruising and swelling for at least the first 7 to 10
days.

Fluid may drain from the incision sites for several days. You may be given
antibiotics to reduce the risk of infection.

Most people are able to get up and move around as soon as the treatment
is finished and after the effects of the anesthesia and any sedation have worn
off. You can return to your normal activities as soon as you feel comfortable,
although this may take several days to a few weeks. Most people can return to
work within a few days. Recovery may take longer if large areas were treated.

Why It Is Done

The main purpose of liposuction is to
reshape one or more areas of your body, not to reduce body weight. Liposuction
is typically used on "problem" areas that have not responded well to diet and
exercise. These areas are often on the outer thighs and hips on women and the
waist and back on men. The face, neck, abdomen, back, buttocks, legs, and upper
arms are all commonly treated areas.

Liposuction is sometimes used
in combination with other cosmetic surgery procedures, such as a "tummy tuck"
(abdominoplasty), breast reduction, or face-lift.

Liposuction may
also be used to treat certain medical conditions, including:

Benign fatty tumors
(lipomas).

Abnormal enlargement of the male breasts (gynecomastia
or pseudogynecomastia).

Problems with metabolism of fat in the body
(lipodystrophy).

Excessive sweating in the armpit area (axillary
hyperhidrosis).

Liposuction is not used to treat obesity. It will not get
rid of cellulite or stretch marks.

How Well It Works

Liposuction is usually very effective
at removing fat deposits in small areas. But if you regain weight after having
liposuction, the fatty bulges that were removed are likely to return or may
appear in a different place.

Some improvement in body contour is
usually noticeable right after surgery. And improvement may continue for
several weeks or even months as the swelling goes away. The full effects of
having liposuction may not be visible for several months to a year.

Liposuction (except for laser liposuction) generally does not tighten the skin over the treated area.
After fat has been removed, the skin around the area may be somewhat loose. It
may take up to 6 months for the skin to tighten around the treated area. Some
people's skin is very elastic and retracts more quickly than other people's
skin. Younger skin tends to have greater elasticity than older skin.

People who expect liposuction to help them lose weight are usually
disappointed.

Risks

Liposuction done by an experienced doctor in
a properly equipped facility is usually safe.1 Having
more than one area treated, or having a very large area treated, may increase
the risk of complications during or after the procedure.

Common
side effects of liposuction include:

Temporary swelling, bruising, soreness, and
numbness in and around the treated areas.

Irritation and minor scarring around the incision sites where the
cannulas were inserted.

Baggy or rippling skin. The skin will
usually tighten and retract after a few months. But in some people the skin may
remain somewhat loose.

Less common side effects include:

Permanent color changes in the
skin.

Uneven skin surface over the treated area.

Damage to the nerves and skin. The heat generated during
ultrasound-assisted liposuction may burn the skin or damage the tissue under
the skin.

If you gain weight after having liposuction, your body may store the new fat in a different place than where you had fat cells removed. New fat can grow deep inside your body, around your organs, such as your heart or liver. This type of fat can be more harmful to your body than fat that is stored near the surface of your body, such as on your hips or thighs. So people who have liposuction need to be careful not to gain extra weight.

Dangerous complications

Although death is very rare
with liposuction, it can happen. If you are having a large amount of fat
removed, are
obese, or have health problems, your risks go up. Possible
complications include:

Excessive blood and fluid loss, leading to
shock. But this is extremely unlikely.

Fat clots or blood clots, which may travel to the lungs
(pulmonary embolism) and become life-threatening.

Buildup of fluid
in the lungs (pulmonary edema). This is most likely to occur when a large
volume of fluid is injected into the body.

Infection. In some cases, antibiotics may be given before or
after liposuction to help prevent infection.

Toxic reaction to the
injected solution (lidocaine toxicity), especially if large areas or many areas are treated at one time.

A puncture into the cavity
containing the abdominal organs or damage to an organ such as the
spleen.

Liposuction should not be done in people who have severe
heart problems, who have blood-clotting disorders (such as thrombophilia, a disorder in
which the blood clots easily or excessively), or during pregnancy.

What To Think About

Liposuction should be done only by
a doctor who has special training in liposuction and surgery of the skin and in
how to respond to complications during surgery. You will also be at less risk
for complications if liposuction is not done at the same time as other cosmetic
procedures.

If you are trying to lose
weight, liposuction is not a substitute for exercise and a balanced diet. In
fact, most cosmetic surgeons agree that the best candidates for liposuction are
healthy people who are at or close to a healthy weight but who have stubborn
fat deposits that do not respond to exercise.

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